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NPI 1316969694 · Middletown, RI · MOHS-Micrographic Surgery Physician
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Jason Michaels is a mohs-micrographic surgery physician provider located in Middletown, Rhode Island. This profile covers 50 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Jason Michaels |
| Address | 102 Valley Road |
| City | Middletown |
| State | RI |
| ZIP | 02842 |
| Taxonomy | MOHS-Micrographic Surgery Physician |
| NPI Enumerated | July 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $982.9K |
| Medicaid | $59.5K |
Specialty and service mix: The provider is listed under taxonomy MOHS-Micrographic Surgery Physician and Medicare billings are dominated by Mohs surgical codes 17311, 17312, and 17313, consistent with a practice focused on skin cancer excision and margin-controlled repair. Complementary procedure codes for wound repair (13132, 13121, 13131) plus biopsy and lesion-destruction codes (11102, 17000, 17110) show the practice provides end-to-end procedural dermatologic care from diagnosis to complex reconstruction.
Medicare revenue concentration: Total Medicare revenue on file is $982.9K, and the precomputed top-three Medicare codes (17311/17312/17313) account for 56.9% of that Medicare revenue, indicating heavy dependence on Mohs procedures as the primary revenue stream. The single largest Medicare code is 17311 ($327.8K, 35.2% of Medicare revenue), underlining the centrality of multistage Mohs cases to the practice economics.
Payer mix and scale: Medicare dominates this provider’s public-payer mix with $982.9K in Medicare revenue versus $59.5K in Medicaid revenue, so Medicare is the operational and financial driver and Medicaid is a comparatively small revenue source. Medicaid billing appears narrowly focused: the precomputed top-three Medicaid codes account for 100.0% of Medicaid revenue and are limited to E&M visits (99203 and 99213).
Medicare competitive standing for Mohs: The provider’s Mohs volumes are above typical national medians but not at the very top tier — 17311 ranks #312 of 2969 providers nationally (89th percentile, described as typical/unremarkable volume), 17312 ranks #285 of 2770 (90th percentile), and 17313 ranks #291 of 2300 (87th percentile). These placements indicate a strong, established Mohs practice relative to peers without being a dominant national outlier for those specific procedure codes.
High office-visit throughput and outlier E&M activity: Office E&M codes show unusually high Medicare volumes relative to national peers — 99213 has 909 Medicare claims ($58.2K) and is labeled an "extreme outlier, far above typical national volume" (98th percentile), and 99203 (239 claims, $17.2K) is also an "extreme outlier" (98th percentile). This combination of high E&M and procedural billing suggests a busy clinic with large patient throughput in addition to Mohs procedures.
Reconstructive and procedural outliers: Several repair and lesion-removal codes are notably above typical volumes, which supports substantial reconstructive workload after excisions. For example, 13131 (132 claims, $21.5K) ranks #18 of 757 providers nationally (98th percentile; "extreme outlier, far above typical national volume") and 11300 (178 claims, $10.3K) ranks #45 of 1624 (97th percentile; "notably above typical national volume"), indicating outsized activity in complex closures and lesion excisions relative to peers.
Medicaid footprint and in-state standing: Medicaid billing is limited to office visits with 99203 generating $32.1K (53.8% of Medicaid revenue) and 99213 generating $27.6K (46.2% of Medicaid revenue). In-state rank positions are modest: 99203 ranks #88 of 346 providers in-state (75th percentile) and 99213 ranks #895 of 2046 (56th percentile), so the provider is a typical to modest participant in Rhode Island Medicaid E&M services rather than a statewide leader.
Tenure and practice stability: The NPI was enumerated on 2006-07-24 (~20 years ago), indicating long-standing enrollment and likely an established practice footprint. Coupled with the concentrated Medicare Mohs revenue and sustained E&M volumes, the data support a stable, Mohs-focused surgical dermatology practice with consistent referral and patient-flow patterns over time.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
50 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 17311 | Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the… | 620 | $530 | $327.8K |
| 17312 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 370 | $350 | $127.3K |
| 17313 | Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins. | 150 | $490 | $73.8K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 910 | $60 | $58.2K |
| 13132 | The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive… | 190 | $210 | $38.5K |
| 17000 | The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion. | 810 | $40 | $30.6K |
| 13121 | This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size. | 130 | $220 | $28.8K |
| 17110 | The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or… | 330 | $80 | $27K |
| 11102 | The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. | 390 | $60 | $24K |
| 13131 | The provider repairs a wound measuring 1.1 cm to 2.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive… | 130 | $160 | $21.5K |
Showing 1–10 of 50
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 50 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
50 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 17311 | 1 | 10 | 310 | $440 | $137.5K |
| 17312 | 1 | 10 | 150 | $320 | $58.4K |
| 17313 | 2 | 10 | 100 | $440 | $46.4K |
| 13132 | 2 | 10 | 130 | $190 | $26.5K |
| 17314 | 3 | 10 | 30 | $320 | $13.6K |
| 14060 | 3 | 10 | 20 | $570 | $13.1K |
| 13131 | 1 | 10 | 80 | $160 | $12.5K |
| 99214 | 932 | 1,950 | 100 | $80 | $11.7K |
| 13151 | 1 | 10 | 60 | $180 | $10.9K |
| 13121 | 1 | 10 | 30 | $190 | $10.7K |
Showing 1–10 of 50
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 290 | $110 | $32.1K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 410 | $70 | $27.6K |
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 895 | 2,050 | 300 | $50 | $72.3K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 88 | 350 | 80 | $90 | $40.5K |
Other providers in the same ZIP code as Jason Michaels, ranked by combined Medicare and Medicaid revenue.
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